Maternity Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

New problemsBack to the course

In the print window, choose “Save as PDF” to keep a copy on your device.

1Formulas and methods

Maternity & obstetric nursing

Method

  1. Place the woman in time: weeks of pregnancy, stage of labour or day after birth, and decide what is normal at that point.
  2. Look for the patient in danger: the mother, the fetus or the newborn, or more than one of them.
  3. Link the finding to its cause: VEAL CHOP for decelerations, the four Ts for bleeding, BUBBLE-HE after birth.
  4. Choose the action that improves blood flow and oxygen first (side-lying, stopping oxytocin, fundal massage), then escalate.

Dosage calculations

Dose from strength
volume = dose / strength
Weight-based dose
dose = mg/kg × body weight
Tablets
number = dose / tablet strength
Units
1 g = 1000 mg, 1 mg = 1000 mcg

Method

  1. Convert the ordered dose and the stock strength to the same unit.
  2. Use desired over have times quantity: (D/H) × Q.
  3. For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
  4. Estimate first and check that the answer is reasonable.

IV infusion rates

Pump rate
mL/h = volume (mL)/time (h)
Drip rate
drops/min = volume (mL) × drop factor / time (min)
Infusion time
time (h) = volume (mL)/rate (mL/h)

Method

  1. Pump rate in mL/h: volume divided by time in hours.
  2. Drip rate in drops/min: volume × drop factor divided by time in minutes.
  3. For time remaining: volume left divided by the rate.
  4. Round as the question or the equipment requires.

2Practice problems

1.Maternity & obstetric nursingMedium

A woman 1 day after birth has a blood pressure of 150/96 mmHg and a headache. She had normal blood pressures in pregnancy. What should the nurse do?

  1. AReport it and assess for postpartum pre-eclampsia
  2. BEncourage her to walk to lower her blood pressure
  3. CGive paracetamol (acetaminophen) and ignore the blood pressure
  4. DReassure her that this is normal after birth
2.Maternity & obstetric nursingHard

A woman in labour is 8 cm dilated. The fetal heart rate shows decelerations that begin and end with each contraction and mirror its shape, with moderate variability. What is appropriate?

  1. APrepare for an emergency caesarean birth
  2. BTurn off the monitor to reduce anxiety
  3. CStop all fluids
  4. DContinue to monitor; this pattern is benign
3.Dosage calculationsMedium
024681010 mL

A child weighing 10 kg is prescribed 4 mg/kg of a drug. The stock solution contains 40 mg/mL. Draw up the dose: what volume V do you give?

10 kg4 mg/kg40 mg/mL
V = mL
4.Dosage calculationsHard
250 mg/5 mLV = ? mL

A patient weighs 160.6 lb. The prescription is 0.5 mg/kg as a single dose, and the stock contains 250 mg in 5 mL. Using 1 kg = 2.2 lb, what volume V do you give?

160.6 lb0.5 mg/kg250 mg/5 mL1 kg = 2.2 lb
V = mL
5.IV infusion ratesMedium
1500 mL20 gtt/mL5 h? gtt/min

Infuse 1500 mL over 5 hours with a giving set of 20 gtt/mL. Find the drip rate R in drops per minute.

1500 mL5 h20 gtt/mL
R = gtt/min
6.IV infusion ratesHard
250 mg250 mL20 gtt/mL75 mg/h? gtt/min

250 mg of a drug is diluted in 250 mL and given by gravity through a set of 20 gtt/mL. The order is 75 mg per hour. Find the drip rate R in drops per minute.

250 mg/250 mL75 mg/h20 gtt/mL
R = gtt/min

3Solutions

1.Maternity & obstetric nursing

Answer: A · Report it and assess for postpartum pre-eclampsia

Why this is the answer

New hypertension with a headache after birth can be postpartum pre-eclampsia, even with normal readings in pregnancy. The nurse reports it, checks urine protein and symptoms and follows the protocol.

Answer

A · Report it and assess for postpartum pre-eclampsia
2.Maternity & obstetric nursing

Answer: D · Continue to monitor; this pattern is benign

Why this is the answer

These are early decelerations, caused by head compression in active labour. With moderate variability they are reassuring, and no intervention is needed beyond continued monitoring.

Answer

D · Continue to monitor; this pattern is benign
3.Dosage calculations

Answer: V = 1 mL

Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.

Dose from body weight

D = 4·10 = 40 mg

Volume

V = 40/40 = 1 mL

On the syringe

On this 10 mL syringe every small line is 0.2 mL.

Answer

V = 1 mL
4.Dosage calculations

Answer: V = 0.73 mL

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

Weight in kg

160.6/2.2 = 73 kg

Dose

0.5·73 = 36.5 mg

Volume

V = (36.5/250)·5 = 0.73 mL

Answer

V = 0.73 mL
5.IV infusion rates

Answer: R = 100 gtt/min

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

Time in minutes

5·60 = 300 min

Drip rate

R = 1500·20/300 = 100 gtt/min

Answer

R = 100 gtt/min
6.IV infusion rates

Answer: R = 25 gtt/min

Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).

Concentration

250/250 = 1 mg/mL

Volume per hour

75/1 = 75 mL/h

Drip rate

R = 75·20/60 = 25 gtt/min

Answer

R = 25 gtt/min

ExamProblems · examproblems.com/courses/maternity-nursing